Facial Rejuvenation with Concentrated Lipograft—A 12 Month Follow-Up Study

Lipofilling is a popular technique to treat volume loss in aging patients. The isolated adipose tissue is composed of adipocytes and stromal vascular fraction cells, which include adipose-derived stem cells (ASC). We hypothesize that the patient’s wrinkle severity scale (WSS) and patient’s satisfaction on the global aesthetic improvement scale (GAIS) can be improved after using concentrated lipoaspirate. Fourteen patients (54 years ± 11.09 years) with volume loss in the midface area underwent waterjet-assisted liposuction (Human Med AG, Schwerin, Germany). Fat was centrifuged in an ACP Double Syringe (Arthrex GmbH, Munich, Germany) using Rotofix 32A centrifuge (Andreas Hettich, GmbH & Co.KG, Tuttlingen, Germany). Homogenization was performed using the double syringe and a 1.4 mm female–female luerlock connector. After a second centrifugation, patients received periorbital (PO) and nasolabial (NL) lipografting. ASC count was performed after enzymatical digestion. Vitality of cells was assessed using a resazurin assay. During long-term follow up (12 months, n = 10), we found a high patient’s satisfaction (GAIS 1+/−0.52) and a good improvement of the WSS during short- and long-term follow-up. The ASC count of processed lipoaspirate was 2.1-fold higher than of unprocessed lipoaspirate (p < 0.001). The difference of ASC in sedimented and simply centrifuged lipoaspirate was also significant (p < 0.05). Facial rejuvenation with concentrated fat graft offers good results concerning objective aesthetic outcome and patient’s satisfaction.

[1]  P. Oefner,et al.  Shear Force Processing of Lipoaspirates for Stem Cell Enrichment Does Not Affect Secretome of Human Cells Detected by Mass Spectrometry In Vitro , 2020, Plastic and reconstructive surgery.

[2]  M. Barone,et al.  Midface Lift Plus Lipofilling Preferential in Patients with Negative Lower Eyelid Vectors: A Randomized Controlled Trial , 2020, Aesthetic Plastic Surgery.

[3]  Shaili Gal,et al.  An Update on Cryopreservation of Adipose Tissue. , 2020, Plastic and reconstructive surgery.

[4]  F. Lu,et al.  Fat Grafting for Facial Rejuvenation Using Stromal Vascular Fraction Gel Injection. , 2020, Clinics in plastic surgery.

[5]  G. Rigotti,et al.  Fat Grafting for Facial Contouring Using Mechanically Stromal Vascular Fraction-Enriched Lipotransfer. , 2020, Clinics in plastic surgery.

[6]  K. Błochowiak,et al.  Another face of dermal fillers , 2019, Postepy dermatologii i alergologii.

[7]  G. Tartaro,et al.  Skin Necrosis and Vision Loss or Impairment After Facial Filler Injection. , 2020, The Journal of craniofacial surgery.

[8]  Qiang Li,et al.  Autologous fat graft assisted by stromal vascular fraction improves facial skin quality: A randomized controlled trial. , 2019, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[9]  J. Rubin,et al.  The Architecture of Fat Grafting II: Impact of Cannula Diameter , 2018, Plastic and reconstructive surgery.

[10]  I. Suh,et al.  Clinical Impact of Highly Condensed Stromal Vascular Fraction Injection in Surgical Management of Depressed and Contracted Scars , 2018, Aesthetic Plastic Surgery.

[11]  D. Elyassnia,et al.  Facial Fat Grafting: Why, Where, How, and How Much , 2018, Aesthetic Plastic Surgery.

[12]  A. Sbarbati,et al.  A Non-Enzymatic Method to Obtain a Fat Tissue Derivative Highly Enriched in Adipose Stem Cells (ASCs) from Human Lipoaspirates: Preliminary Results , 2018, International journal of molecular sciences.

[13]  N. Pallua,et al.  Enhancement of Progenitor Cells by Two-Step Centrifugation of Emulsified Lipoaspirates , 2018, Plastic and reconstructive surgery.

[14]  M. Tremp,et al.  Facial Contouring by Targeted Restoration of Facial Fat Compartment Volume: The Midface. , 2017, Plastic and reconstructive surgery.

[15]  Lukas Prantl,et al.  A Proposal for Updated Standards of Photographic Documentation in Aesthetic Medicine , 2017, Plastic and reconstructive surgery. Global open.

[16]  Patrick S. Cottler,et al.  Effects of Collagenase Digestion and Stromal Vascular Fraction Supplementation on Volume Retention of Fat Grafts , 2017, Annals of plastic surgery.

[17]  P. Vogt,et al.  [Current German and American guidelines for autologous fat grafting - a transatlantic comparison]. , 2017, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V....

[18]  L. Prantl,et al.  Semi-automated extraction and characterization of Stromal Vascular Fraction using a new medical device. , 2017, Clinical hemorheology and microcirculation.

[19]  L. Prantl,et al.  Transcription Profile in Sporadic Multiple Symmetric Lipomatosis Reveals Differential Expression at the Level of Adipose Tissue–Derived Stem Cells , 2016, Plastic and reconstructive surgery.

[20]  F. Picard,et al.  Platelet-Rich Plasma with Basic Fibroblast Growth Factor for Treatment of Wrinkles and Depressed Areas of the Skin. , 2016, Plastic and Reconstructive Surgery.

[21]  P. Vogt,et al.  Aktuelle Erkenntnisse zur Eigenfett Transplantation anhand der neuen Leitlinie „Autologe Fetttransplantation“ , 2016, Handchirurgie · Mikrochirurgie · Plastische Chirurgie.

[22]  J. Rubin,et al.  The Current State of Fat Grafting: A Review of Harvesting, Processing, and Injection Techniques , 2015, Plastic and reconstructive surgery.

[23]  A. Hazen,et al.  Roll, Spin, Wash, or Filter? Processing of Lipoaspirate for Autologous Fat Grafting: An Updated, Evidence-Based Review of the Literature , 2015, Plastic and reconstructive surgery.

[24]  M. Friji Nanofat grafting: basic research and clinical applications. , 2014, Plastic and reconstructive surgery.

[25]  A. Ibatici,et al.  Comparison of Cell Number, Viability, Phenotypic Profile, Clonogenic, and Proliferative Potential of Adipose-Derived Stem Cell Populations Between Centrifuged and Noncentrifuged Fat , 2014, Aesthetic Plastic Surgery.

[26]  L. Prantl,et al.  Adipose Tissue-Derived Stem Cell Secreted IGF-1 Protects Myoblasts from the Negative Effect of Myostatin , 2014, BioMed research international.

[27]  S. Geis,et al.  Pressure monitoring during lipofilling procedures. , 2014, Clinical hemorheology and microcirculation.

[28]  Louis Casteilla,et al.  Stromal cells from the adipose tissue-derived stromal vascular fraction and culture expanded adipose tissue-derived stromal/stem cells: a joint statement of the International Federation for Adipose Therapeutics and Science (IFATS) and the International Society for Cellular Therapy (ISCT). , 2013, Cytotherapy.

[29]  S. Saba,et al.  A Comparison of Cell-Enriched Fat Transfer to Conventional Fat Grafting after Aesthetic Procedures Using a Patient Satisfaction Survey , 2013, Annals of plastic surgery.

[30]  Rod J. Rohrich,et al.  Fat Grafting: Evidence-Based Review on Autologous Fat Harvesting, Processing, Reinjection, and Storage , 2012, Plastic and reconstructive surgery.

[31]  P. Gentile,et al.  Concise Review: Adipose‐Derived Stromal Vascular Fraction Cells and Platelet‐Rich Plasma: Basic and Clinical Implications for Tissue Engineering Therapies in Regenerative Surgery , 2012, Stem cells translational medicine.

[32]  F. Guilak,et al.  Concise Review: Adipose‐Derived Stromal Vascular Fraction Cells and Stem Cells: Let's Not Get Lost in Translation , 2011, Stem cells.

[33]  P. Vogt,et al.  [BEAULI™--a new and easy method for large-volume fat grafts]. , 2010, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V....

[34]  I. Pitanguy,et al.  Influence of decantation, washing and centrifugation on adipocyte and mesenchymal stem cell content of aspirated adipose tissue: a comparative study. , 2010, Journal of plastic, reconstructive & aesthetic surgery : JPRAS.

[35]  L. Prantl,et al.  Harvesting human adipose tissue-derived adult stem cells: resection versus liposuction. , 2009, Cytotherapy.

[36]  L. Bucky,et al.  The Role of Autologous Fat and Alternative Fillers in the Aging Face , 2007, Plastic and reconstructive surgery.

[37]  P. Persichetti,et al.  Digital Photography in Plastic Surgery: How to Achieve Reasonable Standardization Outside a Photographic Studio , 2007, Aesthetic Plastic Surgery.

[38]  S. Coleman Structural Fat Grafting: More Than a Permanent Filler , 2006, Plastic and reconstructive surgery.

[39]  T. Lim,et al.  Viability and adipogenic potential of human adipose tissue processed cell population obtained from pump-assisted and syringe-assisted liposuction. , 2005, Journal of dermatological science.

[40]  I. Jackson,et al.  Guidelines for Standard Photography in Plastic Surgery , 2001, Annals of plastic surgery.

[41]  S. Coleman Structural fat grafts: the ideal filler? , 2001, Clinics in plastic surgery.

[42]  M. Furukawa,et al.  Microvascular Angiogenesis and Apoptosis in the Survival of Free Fat Grafts , 2000, The Laryngoscope.

[43]  I. Niechajev,et al.  Long‐Term Results of Fat Transplantation: Clinical and Histologic Studies , 1994, Plastic and reconstructive surgery.

[44]  C. G. Mellow,et al.  Syringe aspiration and fat concentration: a simple technique for autologous fat injection. , 1990, Annals of plastic surgery.